Individual
DR. BEAU BARKER EVANS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
202 S 6TH ST, HENRYETTA, OK 74437-5002
(918) 652-4404
(918) 652-4445
Mailing address
202 S 6TH ST, HENRYETTA, OK 74437-5002
(918) 652-4404
(918) 652-4445
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6188
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200302490A
—
OK
Enumeration date
06/28/2010
Last updated
12/12/2016
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